MEDICARE: DR. KATHLEEN TOMISSER PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1300X	Psychiatric Pharmacist	PH00015255	WA

General Provider Information

NPI Number	:	1609875517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN TOMISSER PHARM.D.

Provider Business Mailing Address
First Line	:	9601 STEILACOOM BLVD SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-7212
Country	:	US
Telephone Number	:	253-756-2521
Fax Number	:	253-756-2707

Provider Business Practice Location Address
First Line	:	9601 STEILACOOM BLVD SW
Second Line	:	DEPT. OF PHARMACY
City	:	TACOMA
State	:	WA
Zip	:	98498-7213
Country	:	US
Telephone Number	:	253-756-2521
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/10/2011

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